Our proposal is a collaborative effort between the University of Alabama at Birmingham (UAB), the National Development and Research Institute, Inc. (NDRI) and the Pirogov Medical University in Vinnitsa, Ukraine. The purpose of this initiative is to strengthen and sustain, through collaborative training and research, the ability of Ukrainian scientists, physicians, and public health practitioners to contribute to clinical, operational and health services research focused on substance abuse treatment and prevention, and prevention and control of the related epidemics of human immunodeficiency virus (HIV) infection with a particular focus on injection drug use (IDU) and the attendant epidemics of human immunodeficiency virus (HIV), sexually transmitted diseases (STD), and tuberculosis (TB). To develop the Pirogov Medical University into a regional center for training and research excellence, we have designed a program of training that will prepare Pirogov scholars and students to address all the key issues pertaining to IDU-related clinical, operational, and health services research in Ukraine as well as to participate effectively in research that addresses global problems in HIV/STD/TB prevention and control emphasizing communities with substantial IDU populations. Our training program is multidisciplinary and includes clinical research, international health, epidemiology, health behavior, biostatistics, health policy, and key principles in both intervention and treatment research. Our research goals are to better understand the IDU epidemic in Ukraine in order to guide treatment and control strategies, as well as to upgrade evidence-based approaches to the closely related epidemics of HIV infection, STDs, and TB in the services of their control and prevention. The selection of the Pirogov Medical University as the key training center was done with four key factors in mind: (1) Pirogov is one of the premier medical schools in all of eastern Europe; (2) Fully one-quarter of Pirogov?s medical students come from outside the Ukraine, making it an international training site; (3) Pirogov and UAB have been collaborating on research and training for over two years and have a written, substantive agreement to collaborate, co-signed by the President of Pirogov Medical University and the Provost of UAB in Birmingham in March 2000; and (4) UAB and NDRI have complementary expertise and have a close working relationship.